Soedarso, Mohamad Adi
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IS NEOBLADDER SAFE FOR HIGH GRADE BLADDER CANCER PATIENTS?: EVALUATION OF RADICAL CYSTECTOMY COMPLICATIONS AND ILEAL NEOBLADDER RECONSTRUCTION IN AMC KARIADI GENERAL HOSPITAL Stephanie, Irene; Soedarso, Mohamad Adi
Indonesian Journal of Urology Vol 26 No 1 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i1.435

Abstract

Objective: The purpose of this study was to evaluate complications of ileal neobladder reconstruction in high grade bladder cancer patients. Material & Methods: The descriptive study included 12 patients who underwent radical cystectomy and bladder reconstruction with ileal neobladder in Academic Medical Center Kariadi General Hospital Semarang from 2009 until 2016. Base data recorded retrospectively and followed at outpatient clinic. The complications were evaluated from perioperative care, postoperative care, and outpatients clinic. Clavien Dindo classification use to rank complication. Results: The average ages distribution range from 39-70 year. There were 2 patients with comorbid of renal failure, 11 patients with history of TUR and 1 patient underwent adjuvant external radiation. There were 11 patients in high grade bladder cancer (≥T3) and 1 patient with T2. Of the 8 patients underwent orthotopic neobladder procedure and 3 patients underwent cutaneous w-shape procedure. From the histopathology results, 10 patients with high grade transitional cell carcinoma, and 2 patients with invasive urothelial cell carcinoma. There were complication caused by neobladder-related of 1 patient with urinary leakage from ureteroileal anastomose, 1 patient with peritonitis caused by ileo-ileal anastomose leakage, and 1 patients with bowel necrosis caused by internal hernia who need re-operation. All neobladder related complication were 4/33%. From neobladder nonrelated of 1 patient with chronic renal disease and sepsis, and 1 patient with acute renal failure and hyperchlor metabolic acidosis. All of neobladder related complications described above end with mortality (2/16%), except the urinary leakage. Conclusion: Our complication and mortality radical cystectomy - neobladder related rate were 33% and 16% compare with literature show 28-64% and 5.1-8.1%, respectively. Patients selection (<T3, no comorbid) and experience according high volume operation can reduced the mortality rate.
A Malignant Melanoma of the Penile : A Very Rare Case Report and Literature Review Wijaya, Yanuar Hendra; Daniswara, Nanda; Santosa, Ardy; Soedarso, Mohamad Adi; Nugroho, Eriawan Agung; Addin, Sofyan Rais
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 1 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (365.521 KB) | DOI: 10.36408/mhjcm.v8i1.576

Abstract

Background: Malignant melanoma of the penis is very rare, accounting for approximately 1.4% of all primary penile carcinomas. With a small prevalence of penile melanoma, there is lack of data about quality of the therapy. The primary treatment of melanoma of the penile is surgical, although there is a lack of consensus regarding the extent of treatment that is indicated. Case Report: A 60-year-old Caucasian man came to Division of Urology, Department of Surgery, Dr. Kariadi General Hospital Semarang with chief complaint painless and fast growing lesions on his penile. His general condition was fine, and has a normal vital signs. On the physical examination of penile region, there were found lesions on the ventral of the glans and penile foreskin and covered with blood and pus, with bilateral inguinal lymph nodes and lung metastasis from Multi Slice Computed Tomography. We already performed partial penectomy and bilateral inguinal lymph nodes dissection with histopathological results a malignant melanoma Clark IV. The final stage of penile melanoma was pT2N1M1. We follow-up the patient until 1 year after procedure, and there wasn’t any recurrence. Conclusion: Malignant melanoma of the penis is rare. Penile melanoma is highly treatable with surgical excision in its early stages because of resistant to both chemotherapy and radiotherapy. Delay in diagnosed and surgical treatment can lead to an adverse prognosis. The anamnesis, physical examination, and imaging studies must be done appropriately to improve the survival.
Seorang Pasien dengan Batu Staghorn Bilateral dan Spondilitis Ankilosis : Laporan Kasus Langka Chandra, Sibin; Addin, Sofyan Rais; Santosa, Ardy; Nugroho, Eriawan Agung; Soedarso, Mohamad Adi; Wibisono, Dimas Sindhu; Daniswara, Nanda
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (401.198 KB) | DOI: 10.36408/mhjcm.v8i2.607

Abstract

Latar Belakang : Spondilitis ankilosis merupakan penyakit peradangan sendi yang bisa mempengaruhi tulang-tulang axial yang dapat menyebabkan nyeri sendi, dan dapat berlanjut kepada penyatuan dari tulang belakang1. Prevalensi penyakit ini diperkirakan mencapai 16,7 dari 10.000 orang di daerah Asia.2 Meskipun penyakit ini utamanya menyerang sendi, tetapi dilaporkan pula bahwa terdapat kasus manifestasi ekstraartikuler seperti halnya nefrolitiasis. Nefrolitiasis menyumbang sekitar 13,6% dari penderita spondilitis ankylosis.3 Kasus Nefrolithiasis Staghorn sinistra dengan spondilitis ankilosis pernah dilaporkan, tetapi belum pernah dengan kasus nefrolithiasis staghorn bilateral4 Tujuan studi kasus ini adalah untuk mengetahui diagnosis dan tatalaksana spondilitis ankilosis dan nefrolitiasis staghorn bilateral. Presentasi Kasus : Seorang pria berumur 38 tahun datang dengan keluhan nyeri hilang timbul pada pinggang sebelah kiri. Pasien sebelumnya telah didiagnosis dengan spondilitis ankilosis dan nefrolitiasis bilateral dekstra dan sinistra serta telah menjalani operasi Percutaneous Nephrolithotomy dekstra pada bulan Juni 2018. Pada pemeriksaan didapatkan keterbatasan gerak sendi tulang belakang dan nyeri ketok kostovertebra di sebelah kanan dan kiri. Dari pemeriksaan foto polos didapatkan gambaran batu staghorn bilateral Kesimpulan : Pasien didiagnosis dengan spondilitis ankilosis dan nefrolitiasis staghorn bilateral. Prosedur penegakan diagnosis melalui anamnesis, pemeriksaan fisik dan pemeriksaan penunjang perlu dilakukan dengan tepat untuk menghindarai kesalahan diagnosa. Penatalaksanaan nefrolitiasis perlu memperhatikan banyak aspek seperti ukuran batu, ketersediaan sarana dan prasarana, serta mobilitas pasien, supaya dicapai tingkat kesembuhan yang tinggi.